Sauer M, Guntinas-Lichius O, Volk GF. Ultrasound
echomyography of facial
muscles in diagnosis and follow-up of facial palsy in
children. Eur J Paediatr
Neurol. 2016 Mar 26. pii: S1090-3798(16)00054-4. doi:
10.1016/j.ejpn.2016.03.006.
[Epub ahead of print]
Abstract
BACKGROUND:
Ultrasonography is a reliable, non-invasive and painless
tool for quantitative assessment of the static and dynamic changes of the
facial muscles in adult patients with facial palsy. Therefore it would also be
worthwhile to establish the method for quantitative analysis of facial muscles
in children with facial palsy to improve and expand the diagnostics for
paediatric facial palsy.
METHODS:
Eight children, aged 1-18 years, with facial palsy of
different aetiology were scanned and their ultrasound-images analysed.
Bilateral scans of the frontal, orbicularis oculi, zygomaticus major,
orbicularis oris, depressor anguli oris, depressor labii inferioris, and
mentalis muscle were performed at rest and if possible during contraction.
Muscle cross-section area, muscle thickness and echo intensity were measured.
RESULTS:
All muscles of our investigation protocol for adults could
also be reliably identified in children. On the paralyzed side of the face a
reduction of muscle size in rest and contraction and higher echo intensity
could be convincingly detected. Based on these observations, we were able to
make well-founded treatment decisions and avoid painful electrophysiological
examinations.
CONCLUSION:
Ultrasonography of facial muscles is also feasible in
children and facilitates diagnostics in children with facial palsy.
Courtesy of:
http://www.mdlinx.com/neurology/medical-news-article/2016/04/13/quantitative-sonography-children-facial-palsy-mimic/6605121/?category=sub-specialty&page_id=2&subspec_id=317
Volk GF, Pohlmann M, Sauer M, Finkensieper M, Guntinas-Lichius
O. Quantitative
ultrasonography of facial muscles in patients with chronic
facial palsy. Muscle
Nerve. 2014 Sep;50(3):358-65
Abstract
INTRODUCTION:
In this study we introduce quantitative facial muscle
ultrasound as a diagnostic tool for patients with chronic unilateral facial
palsy.
METHODS:
Muscle area, thickness, and echo intensity of 6 facial
muscles (frontalis, orbicularis oculi, orbicularis oris, depressor anguli oris,
depressor labii inferioris, and mentalis) and of 2 chewing muscles (temporalis and
masseter, as controls) were measured in 20 patients with chronic facial palsy.
RESULTS:
Aside from 1, all facial muscles were significantly smaller
on the paralyzed side. With exception of frontalis and orbicularis oculi
muscles, all other facial muscles showed significantly higher echo intensity on
the affected side. Muscle size and echo intensity of the chewing muscles showed
no side-to-side asymmetry.
CONCLUSIONS:
Quantitative ultrasound of facial muscles helps to better
characterize their status in patients with chronic facial palsy in the phase of
denervation and during regeneration.
Volk GF, Pohlmann M, Finkensieper M, Chalmers HJ,
Guntinas-Lichius O.
3D-Ultrasonography for evaluation of facial muscles in
patients with chronic
facial palsy or defective healing: a pilot study. BMC Ear
Nose Throat Disord.
2014 Apr 25;14:4.
Abstract
BACKGROUND:
While standardized methods are established to examine the
pathway from motorcortex to the peripheral nerve in patients with facial palsy,
a reliable method to evaluate the facial muscles in patients with long-term
palsy for therapy planning is lacking.
METHODS:
A 3D ultrasonographic (US) acquisition system driven by a
motorized linear mover combined with conventional US probe was used to acquire
3D data sets of several facial muscles on both sides of the face in a healthy
subject and seven patients with different types of unilateral degenerative
facial nerve lesions.
RESULTS:
The US results were correlated to the duration of palsy and
the electromyography results. Consistent 3D US based volumetry through
bilateral comparison was feasible for parts of the frontalis muscle,
orbicularis oculi muscle, depressor anguli oris muscle, depressor labii
inferioris muscle, and mentalis muscle. With the exception of the frontal
muscle, the facial muscles volumes were much smaller on the palsy side
(minimum: 3% for the depressor labii inferior muscle) than on the healthy side
in patients with severe facial nerve lesion. In contrast, the frontal muscles
did not show a side difference. In the two patients with defective healing
after spontaneous regeneration a decrease in muscle volume was not seen.
Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on
the palsy compared with the healthy side.
CONCLUSION:
3D ultrasonography seems to be a promising tool for regional
and quantitative evaluation of facial muscles in patients with facial palsy
receiving a facial reconstructive surgery or conservative treatment.
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